Impact of oral anticoagulation on inhospital mortality of patients with hip fracture – Analysis of nationwide hospitalization data

Abstract

ObjectivesOral anticoagulation (OAC) may have an impact on mortality in cases hospitalized for hip fracture (HF). We studied nationwide time trends of OAC prescriptions and compared time trends of inhospital mortality of HF cases with and without OAC in Germany DesignRetrospective cohort study SettingNationwide German hospitalization, Diagnosis-Related Groups Statistic Patients/ParticipantsAll hospital admissions for HF 60 years and older in the years 2006 through 2020. InterventionAdditional diagnosis with a personal history of long-term use of anticoagulants (ICD code Z92.1). Main Outcome MeasurementsInhospital mortality ResultsCases hospitalized for HF 60 years and older increased by 29.5%. In 2006, 5.6% had a documented history of long-term use of OACs. This proportion rose to 20.1% in 2020. Age-standardized hospitalization mortality in HF cases without long-term use of OACs in males decreased steadily from 8.6% (95% confidence intervals 8.2 - 8.9) in 2006 to 6.6% (6.3 – 6.9) in 2020 and in females from 5.2% (5.0 - 5.3) to 3.9% (3.7 – 4.0). Mortality of HF cases with long-term use of OACs remained unchanged: males 7.0% (5.7 – 8.2) in 2006 and 7.3% (6.7 - 7.8) in 2020, females 4.8% (4.1 - 5.4) and 5.0% (4.7 - 5.3). ConclusionInhospital mortality of HF cases with and without long-term OAC show different trends. In HF cases without OAC, mortality decreased from 2006 to 2020. In cases with OAC such a decrease could not be observed.